Eight American students have graduated from a Cuban medical school after six years of free tuition, giving a fresh boost to the reputation of the communist government's health care system.

The first class of US graduates from the Latin American School of Medicine, a Fidel Castro brainchild on Havana's outskirts, plan to return home and take board exams for licenses to work as doctors in US hospitals.

The Americans were among more than 2,100 students from about 25 countries who received diplomas this week in a high-profile ceremony at Havana's Karl Marx theatre. The six women and two men, all from US ethnic minority backgrounds, said they would use their skills to treat poor people, in keeping with the humanitarian ethos of the school.

"Health care is not seen as a business in Cuba," Kenya Bingham, a 29-year-old Californian, told the Associated Press. "When you are sick they are not going to try to charge you or turn you away if you don't have insurance. We have studied medicine with a humanitarian approach."

The school on a former naval base, opened by President Castro in 1999, offers scholarships to students from around the world and is intended to showcase the island's commitment to universal health care. To boast graduates from the US, an arch-foe which has imposed a decades-long economic embargo, was another public relations coup for a government already basking in the glow from Michael Moore's documentary Sicko. The film contrasts expensive profit-driven health care in the US with free treatment in Cuba.

The first class of US graduates, which started the course in 2001, has been followed by about 90 other Americans. A further 18 are due to enrol next month, making the Americans a small but high-profile minority among the more than 5,000-strong student body.

The communist authorities rely on the US Congressional Black Caucus and a non-profit group, Pastors for Peace, to select candidates. Washington's embargo bans most Americans from travelling to Cuba but an exemption has been made for the medical students.

The diploma is recognised by the World Health Organisation but it is not clear if the US graduates will be eligible to sit the two exams necessary to apply for residency at American hospitals. "Do I think there will be prejudices against us when we go back to the States and are looking for residences? Yes, it's inevitable," said Ms Bingham.

However she was hopeful, given that the first US graduate, Cedric Edwards, is now working at Montefiore hospital in New York's Bronx borough. Unlike this week's graduates Mr Edwards started medical studies in the US and later switched to Havana, graduating two years ago as the sole American.

If they make it the graduates will be part of just 6% of practising doctors from ethnic minority backgrounds, according to the US Association of American Medical Colleges.

Conditions at the Latin American School of Medicine are basic. Students share dormitories, eat beans and rice, and use ancient equipment.

Mr Castro, 80, did not attend Tuesday's graduation ceremony. His last public appearance was at last year's anniversary of the July 26 1953 attack on the Moncada military barracks which launched the revolution. Raul Castro, who is standing in as president while his brother convalesces from surgery, is expected to address today's anniversary celebrations.